Organization
CANYON GATE MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKI MOSKOW (PRESIDENT)
(954) 656-8855
Entity
Organization
Contact information
Practice address
3201 S MARYLAND PKWY, 400, LAS VEGAS, NV 89109-2441
(702) 262-1130
(702) 262-1161
Mailing address
2929 N UNIVERSITY DR, SUITE # 110, CORAL SPRINGS, FL 33065-5081
(954) 656-8855
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12804
NV
Other
Enumeration date
09/04/2008
Last updated
02/05/2010
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